SLPOtherJournal of autism and developmental disorders2026

Brief Report: Relationships Between Caregiver-Reported Externalizing and Internalizing Behaviors and the Modified Checklist for Autism in Toddlers.

Jane Marryat, Naomi O Davis, Reginald Lerebours and 7 others

PMID 38995481

WHAT IT FOUND

Toddlers with caregiver-reported autism behaviors plus ADHD or externalizing problems had higher M-CHAT-R/F scores.

Adding internalizing problems did not show the same pattern. A positive screen still needs comprehensive assessment.

Key findings

01Caregiver-reported externalizing, internalizing, autism, ADHD, and anxiety behaviors each had modest positive correlations with final M-CHAT-R/F scores.

02Toddlers with elevated autism plus ADHD or externalizing scores had higher final M-CHAT-R/F scores than those with elevated autism scores only.

03Toddlers with elevated autism plus internalizing scores did not show a difference from those with elevated autism scores only.

STILL TO COME

How it was doneWhat they foundWhat it means for SLPs

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What it does not show

The study used caregiver report and did not confirm autism or emotional/behavioral diagnoses. Questionnaire order was not standardized, so answers on one form may have influenced answers on the other. The sample came from primary care clinics and required caregivers to speak English or Spanish, so it may not represent all toddlers. The study did not follow children to see whether they later received diagnoses or referrals.

Declared interests

No funding source is stated. Dr. Dawson reported advisory board, consulting, speaker, book royalty, stock, and licensed technology interests. Dawson, Carpenter, and Duke University benefited financially from licensed technology, data, or products.

The easy way to misread this

Do not read higher M-CHAT-R/F scores in toddlers with elevated ADHD or externalizing behaviors as proof of autism. The study used caregiver report and did not confirm diagnoses.

Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →